Active NPI
Stephanie Adamczyk, PA
- Physician Assistant
- Milwaukee, WI
National Provider Identifier
1063007441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5462
- Practice address
- 945 N 12TH St
Milwaukee, WI 53233-1305 - Phone
- (414) 219-2000
- NPI assigned
- Mar 8, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5462 | WI | Primary |
Addresses
Primary practice location
945 N 12TH St
Milwaukee, WI 53233-1305
Mailing address
945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-2000
Other practice location 1
507 North 17th street
Milwaukee, WI 53233
Phone (414) 288-0607
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100174592 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sadamczyk310890@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5462 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients |
Locations
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
29373 Network Pl
Chicago, IL 60673
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- General Acute Care Hospital
- Downers Grove, IL
- NPI 1578670543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637193600000",
"number": "1063007441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "945 N 12TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532331305",
"telephone_number": "414-219-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 N 12TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532331305",
"telephone_number": "414-219-2000"
}
],
"practiceLocations": [
{
"address_1": "507 North 17th street",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "53233",
"country_code": "US",
"telephone_number": "414-288-0607",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ADAMCZYK",
"first_name": "STEPHANIE",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-08",
"last_updated": "2021-11-18",
"certification_date": "2021-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "5462",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100174592",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sadamczyk310890@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "945 N 12th St",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532331305",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "945 N 12th St",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532331305",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.